Clinical value of echocardiogram and myocardial enzymes detection in patients with acute pulmonary embolism
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摘要: 目的 探讨超声心动图及心肌酶谱检测在急性肺栓塞(acute pulmonary embolism,APE)中的临床应用价值。 方法 选取2014年6月—2016年5月于杭州师范大学附属医院就诊的急性肺栓塞患者60例作为研究组。另选同期健康体检者60例作为对照组。采用超声心动图观察2组右室舒张末期容积(EDV)、收缩末期容积(ESV)、每搏输出量(SV)、射血分数(EF),峰值排空率(PER)和峰值充盈率(PFR)之间的差异,采用全自动生化仪检测2组血清心肌酶谱指标肌酸激酶(CK)、肌酸激酶同工酶(CK-MB)、乳酸脱氢酶(LDH)、谷草转氨酶(AST)水平差异,并观察心功能不全患者与心功能正常者肺栓塞恶化及死亡情况。 结果 与对照组相比,研究组患者EDV、ESV明显增大(P<0.05),SV有所下降,但2组差异无统计学意义(P>0.05),EF、PER、PFR明显减小(P<0.05);研究组CK、CK-MB、LDH、AST指标水平均明显高于对照组(P<0.05);60例急性肺栓塞患者中心功能不全者29例,心功能异常者肺栓塞相关恶化率及病死率均明显高于心功能正常者(P<0.05)。 结论 超声心动图有助于评价急性肺栓塞患者的右心功能,心肌酶谱检测有助于评估急性肺栓塞患者的心肌损伤情况,超声心动图及心肌酶谱检测有助于患者诊断和预后评估。Abstract: Objective To investigate the clinical value of echocardiogram and myocardial enzymes detection in patients with acute pulmonary embolism(APE). Methods A total of 60 acute pulmonary embolism patients were selected as research group(n=60) and 60 physical examination individuals as control group(n=60).The echocardiogram(EDV,ESV,EF,PER and PFR) and levels of myocardial enzymes(CK,CK-MB,LDH and AST) were tested.The pulmonary embolism-associated deterioration and death were compared between the patients with right ventricular dysfunction and the subjects with normal right heart function. Results Compared with the control group,EDV and ESV of the research group were significantly higher(P<0.05),EF,PER and PFR were significantly lower than those in control group,but SV has no significant difference between the two groups(P>0.05);The levels of CK,CK-MB,LDH and AST of the research group were significantly higher than those in the control group(P<0.05);In the 60 patients with acute pulmonary embolism,29 patients were with ventricular dysfunction,the incidence of pulmonary embolism-associated deterioration and mortality in these patients were significantly higher than the individuals with normal right heart function(P>0.05). Conclusion Echocardiography can help to evaluate right ventricular function in patients with acute pulmonary embolism,while myocardial enzymes detection will contribute to assess myocardial injury.Echocardiography and myocardial enzyme detection may be helpful to the diagnosis and prognosis evaluation of patients.
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Key words:
- Echocardiogram /
- Myocardial enzymes /
- Acute pulmonary embolism
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